Hello, it's Anthony Chadwick from the webinar Vet welcoming you to another episode of Vet Chat. We are in the month of February. The, longer days are coming in, the sun is shining.

We are over the worst of it over the winter, but of course February is also veterinary dentistry month. So we wanted to really major and talk a lot about dentistry during this month on the podcast, and I don't think we've got, we could get anybody better than Stacey Parker. Who is a referral, dental and anaesthesia nurse at Perry referrals, so that's Rachel's practise down south.

Rachel, well known to many of you as I'm sure Stacey is as well, but of course not everybody will know you, Stacey, so give us a little bit of background about yourself and how did you find yourself in the weird and wonderful world of veterinary dental and anaesthesia? Yeah, hi, thank you so much for having me. You're right, it is a weird and wonderful world of veterinary dentistry and anaesthesia, and I think if you told me 10 years ago when I qualified as a veterinary nurse that this is the role that I would have, I definitely wouldn't have believed you.

I think, you know, even more so back then, dentistry wasn't something that people wanted to get too involved in. The anaesthetics were never fun, the the patients were never well. So yeah, I qualified 10 years ago, in September, which is flown by really quickly in a small practise in Eastbourne with a lovely, lovely team.

I really wanted to learn lots more and see more advanced cases, so I then moved on, to a multi-disciplinary hospital that did first opinion, with some referrals for dentistry, cardiology. I think they also did some skin referrals, and had an out of hours clinic because at that time I'd really interested in emergency care as well. I completed my BSADA merit in emergency critical care and anaesthesia and then my feline nursing certificate as well cos I'm the cat lady.

Always have been quite happy to see and then, I realised working there, I actually met Rachel working at this hospital, as she was training to be a specialist, but I really loved anaesthesia and particularly anaesthesia of patients that were older or had, lots of other comorbidities, which often is our dentistry patient. So me and Rachel got on really, really well. I learned a lot.

Still. More of an anaesthesia lady, carried on to my, Nert with improve on anaesthesia, while I was there and I ended up being head of theatre for a year while I was working there. I then decided, That, I just wanted to do my own thing and I was planning on locuming, just spreading my wings and seeing where it went, and then Rachel approached me and asked if I would like to be her anaesthesia nurse.

And as we got on so well and her cases really floated my vote for anaesthesia, and I was starting to become more and more interested in the dentistry side, I said yes, and that was 44 and a bit years ago, yeah, just before the lockdowns. It's only 19, summer, we were having a lovely time and then it all obviously changed a little. But it's the best decision I've ever made, I then did my certificate in dentistry.

And I've since done my advanced certificate in anaesthesia and I'm currently the only nurse with the title of lead vet nurse practitioner in anaesthesia in the UK. So yeah, I am very grateful for the path that I've taken. I wouldn't have seen it coming.

And working with Ray Perry referrals is amazing. There's only I think 8 or 9 now veterinary dental specialists in the UK. So the amount that we can learn from the dentists is is is amazing and it's bringing the opportunities such as being able to sit and chat with you today.

Yeah, we definitely need more dental specialists and just people taking dentistry more seriously. It has come on leaps and bounds. I mean when I went to university it was hardly mentioned at university, we had some lectures but it it wasn't covered in the depth that it probably should be, it's a major part of, Definitely small animal medicine and surgery and.

I think you, you sort of mentioned there often, you know, and not always, but often your dental patients are older. This is the patient, you often, diagnose through smell rather than through actual viewing, and that's often in the, in the waiting area because that Yorkie comes in pretty much with the teeth almost out anyway. This was my level of.

But it was amazing how often I would see a patient and would obviously mention the huge elephant in the room and they'd say, oh yeah, it was kind of mentioned once, but we decided that the dog or the cat was too old to go through an anaesthetic, so we decided to leave it. And I always had a problem cos for me, . You know, I said there's 3 people in the room, there's myself, there's the client, and there's the dog or cat, and the most important person is the dog or the cat.

And I'm afraid that with teeth like that, the dog, you know, the pet must be suffering, must be feeling pain with that and so we can't just leave him or her. We have to do that procedure, knowledgeable that an anaesthetic is clearly, you know, more risky in in an older patient, but with all the advances in anaesthesia. At the same time we'd be really disappointed.

To lose a patient under those circumstances, and it was amazing how satisfying those cases were because a week later they would trot in, to the consulting room post dental work, and the clients would immediately say to you, oh my goodness. What injection have you given my dog or cat because he's 5 years younger than when he came in last week and that was just the burden of pain and infection that was in the mouth. So we are, we are moving on, we've got better tools as well, but those anaesthetics are difficult.

Give me a few, tips, you know, I've not been practising since 2016, so the world has obviously moved on. One of the things that perhaps. Stop people doing that, do you see that still, or do you think that's now has changed and people are much more comfortable doing dentistry?

Yeah, I think you've covered some really valid points in that, yeah, we don't get a huge amount of dentistry education as vets and nurses. Yes, that is on on the turn, but that's going to take some time. But I think people are reaching out to get more of their own education on subjects they feel they may be lacking in, which is fantastic, but it takes a certain level of bravery to to realise where you might be lacking and to support yourself through that.

. And yes, it it does still happen of, you know, I, I don't want them to have an anaesthetic because they're old and when we, as pet owners ourselves, we know that making a decision for our cat or dog to have an anaesthetic is. It's a very emotional experience. It's, it's very stressful and dentistry is often seen as a very much elective procedure, when actually, if you were, you know, you say you can smell these muses and you look at the mouse and think, oh my goodness, we've all had toothache, maybe just from one tooth, I have.

And it just destroys your day, weeks on end if you're still in pain. It takes over your whole face, it goes down your neck, around your shoulders, your tents, you don't sleep well. Your quality of life with a bad pain in your mouth or infection or inflammation is, is not nice.

And if you were to take that amount of infection and inflammation out of the mouth and place it somewhere else on the body, such as on the leg or the top of the head, where the owner would see it every single day. I feel like it might be treated a lot quicker and it wouldn't be seen as elective. It's because it's hidden behind the lips and in the mouth.

And prehistorically it's oh it's just got doggy breath or cat breath, that's normal. So it's trying to change that education and that viewpoint that owners have for them to realise that this is very, very important because as we all know, having bad inflammation and infection in your mouth will cause issues potentially or exacerbate issues they may already you already have with their heart or with their kidneys. Or you know if they're diabetic, they're more prone to having issues and it's much better to prevent dentistry needing to happen, so that's another step we need to look into.

But if they do need our assistance from professional cleaning and X-rays and surgical extractions, it's much better to do that whilst the patient is younger, because yes, they may be 12 and you. You're scared of the anaesthesia, but what if they live to 18 and then they can't eat because we haven't advanced, they haven't gone into this dental treatment. You, you're then even older with less cardiac reserve and potentially those more years to accumulate some more comorbidities.

So I think it's about being brave, and advocating, like you said, for the patient in the room. And being comfortable to educate in a very kind and explainable way to our clients why it's so important that that this is done. And we, I would say 50% of our referrals come in because it's a surgery that the vet doesn't feel they can do, or perhaps it's advanced like acrylic splints for fractured jaws or root canal treatments or.

Crown amputations, but perhaps it is lots of extractions, which the vet would be comfortable to do, but they're not comfortable having that patient under anaesthesia under their care because they may not have the advanced monitoring, they may not have the dental radiography. So I'd say half of our cases come through because we work with a team of anaesthetists and we're very well trained and we have all our advanced monitoring. So if it's not something you're comfortable doing in-house, think about how you can change what you do in-house to be able to accept your geriatric patients, and always know that you're very welcome to refer them to a dentist who works with an anaesthetist.

And if they're seeing a dentist, chances are the dentistry is going to happen in. A lot shorter time as well, so the, the length of anaesthesia is reduced, which will reduce the risk of anaesthesia and, and we certainly see a lot of geriatric patients, you know, we had a 23 year old cat this week. I think the oldest I've done is a 25 year old diabetic cat.

And we, we are going to be doing them in clinic back to your original question, is. How should we keep them safe, so we know that they're more likely to have other comorbidities, that doesn't mean they have. So let's test for them, let's look at them.

Are they clinical signs? Have they got a gallop, have they got a high heart rate? Are they quite skinny and eating and getting quite frenzied by life?

Are we worried about their thyroid? Can we do a spot glucose test? Is that particularly high now do we need to look at it?

It's all about planning. It's not about seeing fluffy that's 22, that looks a bit skinny on the Monday and saying let's do a dental tomorrow. It's about taking a step back and saying we need to do this, but let's plan this and make sure we're doing it safely, and then you will feel much more comfortable with the plan, including the owner.

So it's about, yeah, clinical exam, very, very important, definitely taking your blood pressure, working up any heart murmurs, particularly in cats, because a little heart murmur can be a big problem. Taking a blood test to rule out any comorbidities. This obviously will depend on the owner's financial constraints.

Everyone's in very different positions, so we have to work with that. If there's no clinical signs of any excuse my cat, if there's no clinical signs of any potential disease processes, then we may need to save that money towards something else if they have an allocated, sort of financial, view of, of this procedure. And then really good monitoring under anaesthesia, keeping them warm is, is very easy that we can do that, but very often our our dental patients are getting cold, maintaining a good blood pressure, keeping them less stressed.

There's many, many things that we can do, and having, from a surgeon's point of view, having a good surgical technique, and having the correct tools, so making sure your dentistry instrumentation is the appropriate size for your patient. It's been well maintained and sharpened so that you're able to do your job quickly but to the best of your ability, and just working as a team really and having a good chat about that patient and ensuring that anything that you're worried about, you're prepared to deal with. No, that's fantastic, so many good points there and actually.

It reminded me of when I had my . Problems that during the pandemic, I had a really sore mouth and similarly, you know, to yourself, couldn't sleep. Difficult to get hold of a, of a, a dentist, but finally found one.

And that once the tooth was pulled, it was a, it was a lot better. And then suddenly, Buddy, the cat who adopted me again during the pandemic, just went through a dental procedure a few days ago and. It was really good to see how involved the nurse was in the procedure and how, You know, we compliment each other, you know, obviously as a vet, I brought Buddy in, in an older cat carrier, and when we were taking him home, you know, she said, well, he's been through this procedure, but there's no blanket in there, let's put a blanket in, you know, sometimes.

You know, we just don't think about things, basic things, you know, I'm a vet, I should have remembered that, but I hadn't so it it's so good to have that teamwork of the vet and the nurse working together with their different skill sets. Yeah, we can all learn from one another, so you know, Rachel's saying we need to make sure these instruments are all, you know, up to date and and. Sharpen, that's something I can do, but I might need to be reminded to do that.

And yeah, the simple things like making sure our patients are relaxed. So if I know it's a stressed patient, the last thing I want is a stressed patient going under anaesthesia. I'm gonna discuss the vet with the vet.

So for my case, Rachel, the test, do we need to prescribe something like gabapentin for the stressed cat to have at home? The owner's gonna be more relaxed if fluffy isn't going mental going into the basket. Keeping regularly up to date with your clients during the procedure.

During the procedure day is really important and something that we work really hard to do. And, you know, simple things like, yeah, nice and cosy blanket, we admit our patients straight into the dental suite, they're not getting stressed out in the cattery. So again, the less stress, the less catechobia going around that body for the anaesthesia, which we know is better for them, better for their heart that probably doesn't have as much cardiac reserve if they're an older patient.

And then we're keeping it nice and relaxed, no loud noises, no bright lights, cat music on, fell away. Keeping everything nice and happy or, you know, whatever we have for dogs to keep them comfortable too, if they want to sit on the floor with a nursing assistant and have a cuddle, then great. All of our patients with regards to keeping warm will have a fleecy jacket on them and socks.

We're using the forced warm air circuits if we need to. Making sure we use a puppy pad over their snout once they're incubated and we're doing any form of dentistry with water, which we always do, and that stops the patient getting any water or any debris or anything on their muzzles. So you take it off and they don't look like a bedraggled little one that's had a dental.

They're nice and dry, and that works really well. And there's there's little things that unless you've been told about, you may not think of on your own, as as you said, and there's so much we can do. In a very simple way, reducing our, our, oxygen.

Levels as well will help or keep everything a little bit warmer, it's little steps put together make a huge difference for your patients and also for your stress levels as well. No one wants to feel stressed during an anaesthesia. Both the vet and the nurse, and the vet knowing that the nurse is relaxed and supported will put the vet in a better place to perform that dentistry as well, which is just works really well for the team.

We have talked about dogs a bit, but we've talked about cats quite a lot, so I suppose with the cats, from, from both, servants making an appearance, we probably podcasts, shouldn't we, rather than a podcast. One of our podcasts that we have done over time. I think he was just getting.

Jealous cos your cat was getting all the attention there, so I apologise. She's still sat on my lap having a snuggle, she'll be back, I'm sure. Those of you listening on, on one of the channels, we'll be able to see that the the cats have been moving backwards and forwards across the screen.

You, if you're looking at it as a podcast on our webinar vet channel, then you'll see the cats in, in all their, in all their glory. But of course, I mean, Stacey, you know, very busy obviously as a dental nurse. Working with Rachel, who is, you know, such a fantastic vet, dentist as well, but I mean that's not enough for you, is it really, I mean that kind of.

You're, you're busy but you're not super busy, so you've just decided to start a new business, haven't you, in, in honour of . Should we say a fallen comrade who unfortunately lost a few months ago, so tell us a little bit about Bertie's boutique and what that gets up to. Yeah, so it, it's super exciting and thank you so much for us discussing it together.

I love to talk about it. Yeah, so we work clinically sort of 30 odd hours a week. Obviously you've probably seen Rachel Perry teaching around, she's amazing.

If you can't, haven't caught a lecture of her, hers yet, I obviously am biassed, but she's amazing. You'll learn so much the way she teaches it's really inspiring and amazing, so. That allows me to have a few hours a week and you're right, I, I love to keep busy.

So, yeah, Bertie was my cat, that I had for 10 years. He, as you said, he found me, took me on as a stray, I imagine, when I was a student, 10 years ago, 11 years ago now, and we sadly lost him in January. Of 2023 and you know that that cat that just or dog or rabbit or any animal that just really connects with you.

People like call them your soul, your soul mate in animal form, and I was so lucky, so lucky to have experienced that. But him leaving and him having gone through chemotherapy for 6 to 8 months in the last months of his life, we had, you know, quite a close bond, kind of left me feeling a little bit shell shocked, didn't know what to do with the love that I'd had for him. And I had been doing a little bit of teaching and my own webinars, and I thought, I'm, I'm gonna create something in legacy to him, and he'd always inspired me to learn better, do all my certificates and treat every patient like they were him, really, and I continue to do that.

So yeah, we, I decided, I say we, but it's just me. I've decided to create Bertie's Boutique, which offers relatable, affordable, stress-free veterinary CPD. We launched in October, and we're already doing really well, it's quite overwhelming but lovely.

It's exactly what I needed for, for the grief of losing a, you know, a soul that's that close to you. So we offer monthly webinars, in-house training. We, sell poster guides about capnography.

And, hypertension poster guides and the ECG poster guides being launched in April. We also are holding, face to face events. Our first one is in April and we actually sold out last night, which has blown my mind and it's just lovely.

We actually have a waiting list for our next event which is being planned rapidly. So yeah, we have an Etsy store and our website is being created and being launched at our launch event in April, and it's all about offering, you know, relatable CPD so you can take some nuggets of advice straight from that webinar, or face to face event and, and put it into practise straight away at pracer in your clinic. It's affordable because I don't want to be taking lots of someone's CPD budget, and sometimes our budgets aren't too high or our wages are quite low.

And stress free, so for you to attend stress free, for it to feel stress free for my speakers, for it to be stress free. So that's kind of where we're aiming at, and I'm, I'm really proud of where we are right now. It's been quite a journey, but I'm really, really enjoying it.

I love teaching, I love supporting other nurses, and I love my clinical work, and I feel so lucky to be in a position where I, I can do both. It's, it's really unique and I'm, I'm really, really happy. Oh, fantastic.

And I think that . A key piece as well, when you know I set up Webinar bet it was very much. To help make, you know, vets and nurses more confident, and it was very much at a GP level with vets and nurses.

Is there one thing that you learned from that lecture that you can take home to use in your clinical practise that makes you a better vet or a better nurse, then that hour has been an hour well spent because we can go to things and it can be quite theoretical, which, you know, is also good. But if we're not necessarily taking something back to the practise, then I'm a great believer in. Make it practical, make it useful, make it something that the vets and the nurses can actually go and use, so yeah, well done for you for, for setting that up and looking forward to see how that progresses over the next months and years.

Thank you, yeah, and as I said, it's just so lovely, like the veterinary support from other . Businesses doing similar things, it's just lovely. There's space for everyone and we all learn differently in different ways from different people offering different subjects and different varieties, and I think it's great and you know, like I've, you've just said that you've put the nail on it is that anyone could open a textbook and read a lot of theory and the history behind something, but to be able to watch something, like with your webinar that webinars and everything.

To be able to make a difference to one patient's life from watching that 45 minute hour webinar is, is amazing and the goal. So yeah, I really enjoy the webinar vet webinars, and it's really inspiring and seeing so many good speakers being able to share their knowledge and making such a big difference to patients' lives is, I mean, that's the goal, isn't it? That's why we will be a vet or a nurse is to improve our patient care.

So yeah, it's, it's lovely. Just a final one to finish, obviously, I know Rachel's practise is based out of I think it's we referrals, isn't it, in it's North Down specialist North Down, sorry, so one of the Linnaeus practises, obviously sustainability, really important with Linnaeus and Mars Veterinary Health. How can you as a, as a dental practise, Be more sustainable, we've got all the little, you know, rubber caps for polishing teeth, we've got anaesthetics, you know, are we doing high flow anaesthetic, can we use safe for anaesthetics and so on, what, what sort of things, is that something that's on your radar at er Perry referrals?

Yeah, absolutely, and. So lucky to work out of North Down specialist referrals for many reasons. The team of clinicians are amazing, the setup there is, you know, unreal.

The level of patient care we can offer is amazing and they're also really big on sustainability, which is a big deal for Rachel and I. We, we don't want to be harming the planet. We, no one wants to do that.

Sorry, let's move the cat. So what we want to do is do our part and every little bit adds up. So within dentistry and any surgery, there, there's always gonna be a certain amount of disposing of items that we, we can't do a lot about.

The things that we can do, so for example, if you're, you know, cleaning your dental instruments and such, and then you're putting them on a kennel liner or a puppy pad. You know, we use a bath mat instead and that will absorb the fluid well, and then we can put them through the wash and reuse them. And we do use the puppy pads to go over the face and cut a little hole for the snout because that keeps our patient nice and warm and dry and then I'm less likely to need to turn on the electrical.

Ford warm air blanket, and I'm less likely to need to be warming them more and more postoperatively because they've stayed nothermic. But what I do do is I cut them down, so I don't use a whole sheet for one patient, I'll cut them into 4. So I'm extending how much I can use them.

The biggest thing we can do is, and you touched on it, is to work on low flow anaesthesia, and that can sound really scary if you're not used to it or you don't fully understand it. But reducing the amount of oxygen you're giving to your patient is gonna reduce the amount of inhalants such as isoflow or Siva flow that is then picking up as it goes to your patient. So you're producing less greenhouse gases.

It's also gonna keep your patient a lot warmer because we're not having that high amount of cold air. Going straight into our patient. So there's many ways and different circuits that you can do low flow anaesthesia.

It's really easy to learn about it and the nas have some amazing free stuff on their websites about how to use low flow anaesthesia. So yeah, reusing where you can. And if you are using the forced warm air systems, they do have reusable washable blankets, so you don't have to use the sticky ones.

Keeping our patients warm by fleece jackets and socks work a dream. I no longer use bubble wrap or foil, which does have a lifespan to it. So yeah, there are lots of ways that we can keep our patients.

Warm and safe, and do a really good job whilst also thinking about the planet at the same time as far as we can. And sometimes we do look at using injectable maintenance of anaesthesia with either propofol or alfaxolone. That does need a lot more education behind it, not saying just go and get yourself a syringe.

You need, but then I think they're looking into how much that does help because that does require something being plugged into the electrics and the amount of plastic that you will then be. So I think at the minute that's a little bit, is it better or is it not? I think they're doing a lot more research into it, but it is definitely an option, and we've done that for some of our patients just because their blood pressure couldn't take an inhalant so it was actually safer for us to keep them.

On the tea, so yeah, there's definitely loads of options to be more sustainable, and I'm definitely up for hearing more and more ideas as well for that. Yeah, Stacey, it's really good to see. Obviously the nurse have been leading on this.

We've had Ellie on the, the, the, webinars as well, and we've obviously got some resources for people who perhaps are listening and want to find something somewhere as well, because it is such an important area. It's an area that I've been spending more and more time on because actually, fundamentally it's really difficult to run a practise if there is no planet left. Yes, that would prove to be quite pretty and if there's no planet, there's no cats, and that's not somewhere I want to live.

Exactly, exactly, . Stacey, that's been absolutely fantastic today, really er interesting stuff around those anaesthetizing of older, of older patients, and I think the key message for me was very much around the planning, clinical history. It's very easy to see an animal with a bunch of bad teeth and say right, we need to remove them, without sitting down and saying, well, obviously it's an older animal, we need blood.

We need to see if there's comorbidities there, how do we deal with those. Most of these animals obviously will go on fluids, but we also in cats particularly don't want to overdose with fluids as well, so there's all those sort of areas that. So much to think about.

And ultimately, I treat all my patients the same whether they're 6 months or 20 years. I'm going to be doing a full clinical exam, but I'm more aware that I'm probably going to see something or there's a higher potential. To see something of concern in my older patients because we know they're more prone to comorbidities.

It doesn't mean we're necessarily encroach it, but if I'm then prepared and I've either investigated or ruled it out, I'm more prepared that they're gonna have less of a cardiac reserve, so I'm probably going to have to assist them with their blood pressure. How am I going to do that? Should I calculate some drugs before then?

I'll have that conversation with the vet prior to starting the anaesthesia, so that's happened, so. For example, if they've got a low heart rate of a cat of 80, and the blood pressure is a mean of 60 and it's dropping 55, 50, I know that I'm gonna need to increase that heart rate to increase my blood pressure. What drug are we gonna use?

Let's use some glyco. What dose are we gonna use? Let's go for 5 mcg per kilo.

We've already got that planned. And I always find if you plan something, you're less likely to use it. And with our patients that are older, they've got less muscle mass, so they're more likely to get cold.

Let's get them warm from the beginning, warm room, nice blankets, jacket on if they're let me. As soon as they're sedated, socks are on another blanket. No water is touching my patient, low flow anaesthesia, monitoring that temperature using the forced warm air blankets if I need to.

There's lots of ways that we can, but if we put them into place before the temperature drops, instead of trying to warm our patient, it's much easier to keep them warm than it is to rewarm them. And keeping an eye on that blood pressure from the very beginning and knowing what's normal for them. If I see an older cat that comes in and the heart rate's only 120, I know I'm gonna be giving that drug, that cat, an antihologenic.

I know it's gonna happen, so I've got it ready. But then sometimes I find, particularly with dogs, I find a younger dog might be naughtyer and anaesthesia for me than an older one, and that you can be really surprised. So yes, we've spoken a lot about the.

A huge presentation of patients for dentistry being older, and that is true, but you'll get a lot, particularly dogs for deciduous canine removals or unrupted teeth causing denticulous cysts. So we do or maoclusion treatments. So we still do see a very young population who may just because they're young doesn't mean they're going to behave themselves.

But they're less likely to have a comorbidity and you're less likely going to have to tempt the owner to do something about it because they probably don't have the same level of of concern because they're not classed as geriatric, so I think, Yeah, it's educating people, being prepared, being educated and feeling supported as the team as to how you're going to, to treat that. And I know that's kind of how I started with my mindset of, oh my goodness, I've moved to a big clinic. I only used to have a pulse ox and an esophageal stethoscope, there's a catnograph and there's a blood pressure machine.

That's all very well, but I don't know what this means. I, I don't remember, this is terrifying, so. Took a step back and was like, right, what do I need to be comfortable?

And I'm going to do a webinar on catnography. I'm gonna read a chapter on catnography and I'm gonna apply that. OK, I get that now.

I'm now gonna read about ECGs and I broke it down for myself until I. I understood it, so I felt confident and I know my favourite procedure is a geriatric and a cap for dentistry with comorbidities because I'm comfortable and I understand and like you said, the difference that you see and we call all of our patients the next day. The difference that they see is is is amazing.

The quality of life improvement that we can make is huge and it's sad if we don't get the opportunity to do that based on fear or lack of understanding. No, Stacey's really important, and I looked, . When when I had my own practise Park veterinary centre, our strap line we was we love and care for your pets as if it were our own, and you know, obviously we were saying the same about Bertie as well, so, as sad as it was, it's lovely to leave a legacy for him and best of luck with with all of the Bertie's boutique endeavours.

Thank you, yeah, it's exciting and it's, it's good for the soul to be doing something in his legacy and it's lovely to feel the support from other people, so thank you very much. It makes me very proud. Thanks Stacey.

Thanks everyone for listening to another episode of Vet Chat, the UK's number one veterinary podcast. I'm Anthony Chadwick, this has been the webinar vet, and hopefully we'll see you on a podcast or webinar very soon. Take care.